Community Heath Center Pediatric Dentist Michael Mark examines the teeth of 10-year-old Damarys Antun. The family, which includes mother Carmen Peralta, Diana Antun, 10, and 16-year-old Julia Antun, is from ... more

Photo: Cassandra Day / Hearst Connecticut Media

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From left, Julia Antun, her mother Carmen Peralta and sister Damarys, 10, all of Middletown, don’t presently have dental insurance. They took part in the national Give Kids a Smile program Tuesday at the Community Health Center. less

From left, Julia Antun, her mother Carmen Peralta and sister Damarys, 10, all of Middletown, don’t presently have dental insurance. They took part in the national Give Kids a Smile program Tuesday at the ... more

MIDDLETOWN — Pediatric dentist Michael Mark, who provides care to children from low-income families, decided early in his career that he wanted to help the less fortunate.

Not only does he find satisfaction in encouraging young people to take charge of their own dental hygiene, it’s where his efforts make a more lasting impact.

“I’m doing something that really needs to be addressed,” he said, while Diana Antun, 13, lay in his dental chair at the Community Health Center, her eyes protected from the light with dark sunglasses.

“That’s how I feel about what I do. I could work at a private practice, but I think I’m offering a better benefit by seeing the population that really needs the treatment,” Mark said.

This week, Community Health Centers across Connecticut are participating in the national Give Kids a Smile program administered by the American Dental Association Foundation, now in its 15th year. At the Middletown location at 675 Main St., dentists performed free oral health services Tuesday for their youngest patients who do not have dental insurance . As part of the annual initiative, children receive cleanings, exams, restorative care, fluoride treatments, sealants, fillings and dental education.

Those who have limited income pay on a sliding scale.

Chief Dental Officer Dr. Sheela Tummala, who has been based at the CHC’s Meriden health center for 11 years, has been taking part in Give Kids a Smile since its inception 15 years ago.

“The earlier you get to the child’s oral health, they tend to not have any more cavities,” said Tummala, who works with Head Start programs at many of the school-based health centers. “I see less and less decay,” because she stresses how preventative care, daily brushing, flossing and dietary changes can improve children’s teeth.

Since 2003, when Give Kids A Smile began, more than 5.5 million children have been cared for by more than half a million volunteers through the program.

While Mark worked on her daughter, Carmine Peralta sat in the waiting room with Diana’s sisters, Damarys Antun, 10, and Julia Antun, 16.

Peralta was referred to the program by the CHC at Macdonough Elementary School, where Damarys attends classes. This was their first visit.

She and the girls only speak Spanish. Her daughters only recently arrived in the United States from Ecuador, where they had been living with their grandmother.

“The care in Ecuador is totally different. Technology is much more advanced and professional here, with specialized machinery. It’s much more expensive here,” Peralta said through Senior Patient Services Associate Yajaira Joaquin-Ortiz, who acted as her interpreter.

“There is no dental insurance (in Ecuador). If you are able to pay, you can be seen. If you can’t afford it, you can’t be seen,” said Peralta, who works part time and doesn’t have dental coverage.

Not all foreign-born families receive adequate — or any — dental care outside the States, Tummalo said. “We see a lot of immigrant children who come from countries where they have little knowledge of dentistry. Some people migrate when the children are older, so they didn’t have fluoridated water.”

When Peralta’s youngest returned to the waiting room, Mark told her he found a cavity, which he’ll fill during another session.

Mark said very few of his patients are afraid to be in the chair. “It’s just taking time to work with the children. We don’t have all the fancy sedation or anything like that, but usually if you spend time talking to them, you build up a relationship and they learn to trust you.”

Many kids, even at a young age, make permanent changes in their oral care after their visit.

“They take better care and their diet improves, because if they get a lot of juice and candies and sodas, they’re going to get more problems,” Mark said. “But if they drink more water and milk and they’re taking better care, than we can see [dental issues] reverse.”

Parents also play an important role, however, a large number do go without exams themselves. Approximately one-third of adults have not had a dental visit in the past year, according to the ADA Foundation.

“They really have to lead by example in that. Some kids, though, they’re really meticulous after coming here, and they don’t want any problems, so they get really motivated,” Mark said. “They’re listening.

“But you need the parents to buy in or it’s not going to happen,” he said.

Give Kids a Smile events take place in February every year.

“We try to do as much as we can on that day, even though some children really need a lot of dental work,” Tummala said. “So we try to triage — we do the treatment that really needs to be done in order for the children to function with optimal oral health.”

Sometimes, significant issues arise.

“If a tooth has an abscess and needs to come out, we’ll take care of that on that day — an abstraction or trying to do an apicoectomy,” Tummala said. “We’ll clean out the nerve inside and try to take away the top portion of the pulp chamber.”

Nearly one in four children under 5 already have a cavity, according to the ADA, which said tooth decay is one of the most chronic conditions of childhood in this country, affecting 42 percent of kids 2 to 11 years old.

Medical staff will begin encouraging parents to make regular dental visits when their children are as young as 6 months during routine appointments.

“I see them now bringing the kids now back to the dentist for exams and trying to take care of the babies’ teeth early enough,” Tummala said.

Education and prevention are very important components of success, she added.

“Dental health is often overlooked as an important component of primary care. A lot of health issues are really linked to the greater health indicators and problems, such as plaque inflammation on gums, which can lead to many other systemic diseases,” or losing bone in the teeth, she said.

The CHC sees more uninsured patients than those with private insurance, Mark said. “It’s the 80/20 rule. Twenty percent of the population has 80 percent of the problems. This is pretty typical.”